2-Statement Required Pursuant to KRS45A.395 Page - FINAL.pdf

PDF 198 KB Posted

Attached to
Bulk Salt
Solicitation number
4463
Issued by
Clinton County, Kentucky

About this file

This is a Sworn Statement form required by Kentucky Revised Statute 45A.395, applicable to bidders and offerors seeking contracts with the Commonwealth of Kentucky. The statement serves as a prerequisite certification that neither the bidder nor anyone acting on the bidder's behalf has knowingly violated any provision of Kentucky's campaign finance laws, and that awarding a contract to the bidder will not violate such laws. The form requires the bidder's authorized representative to sign under penalty of perjury and includes fields for the company name, signatory name and title, office or title of the signatory, and the date of execution. The statute defines "knowingly" as awareness or reasonable awareness that conduct violates the law or that a circumstance exists as described in a statute defining an offense.

This document appears to be a standard compliance form unrelated to the described contract opportunity for bulk salt procurement by the City of Owensboro and Daviess County Fiscal Court in Kentucky. Bidders responding to this salt supply contract must complete and submit this sworn statement as part of their bid package to demonstrate compliance with Kentucky campaign finance requirements. No specific pricing information, bid amounts, or contract terms are contained within this form itself, though submission of a completed statement is mandatory for bid consideration.

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STATEMENT REQUIRED PURSUANT TO KRS45A.395

The provisions of KRS45A.395 require that any bidder or offeror submit a sworn statement in conformity with such statute as a prerequisite to a determination that such bidder or offeror is a responsible bidder.

The undersigned, individually and as the________________________________ (office or title) of _________________________________________________ (bidder or offeror) states under penalty of perjury that neither he (she), nor, to the best of his (her) knowledge, anyone acting on behalf of Bidder or Offeror, has knowingly violated any provision of the campaign finance laws of the Commonwealth of Kentucky and that the award of a contract to the Bidder or Offeror will not violate any provision of the campaign finance laws of the Commonwealth. “Knowingly” means, with respect to conduct or to a circumstance described by a statute defining an offense, that a person is aware or should have been aware that his conduct is of that nature or that the circumstance exists.

This _______ day of _____________________, 2025.

Company Name: ________________________________________________

By: ___________________________________________________________

Signature: _____________________________________________________

Title: ________________________________________________________

Company Name:
By:
Title:
office or title:
bidder or offeror:
day:
month:

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